Predictive factors for developing acute cholangitis and cholecystitis in patients undergoing delayed cholecystectomy: a retrospective study

Abstract Background We evaluated the risk of acute cholangitis and cholecystitis while waiting for cholecystectomy for gallstones. Methods We retrospectively enrolled 168 patients who underwent cholecystectomy for gallstones after a waiting period and conservative therapy between April 2014 and March 2018 at our hospital. We compared the clinical data from 20 patients who developed acute cholangitis and cholecystitis while waiting for cholecystectomy (group A) with data from 148 patients who did not develop cholangitis and cholecystitis (group B). The risk factors for developing acute cholangitis and cholecystitis and all patients' surgical outcomes were investigated. Results Preoperatively, significant differences in age (68.6 years vs 60.7 years; p= 0.004) and the number of patients with a previous history of acute grade II or III cholecystitis (55.0% vs 10.8%; p< 0.001) and biliary drainage (20.0% vs 2.0%; p= 0.004) were observed between group A and group B, respectively. Preoperative white blood cell counts (13500/µL vs 8155/µL; p< 0.001) and serum C-reactive protein levels (12.6 mg/dL vs 5.1 mg/dL; p< 0.001) were significantly increased, and serum albumin levels (3.2 g/dL vs 4.0 g/dL; p< 0.001) were significantly decreased in group A vs group B, respectively. Gallbladder wall thickening (≥ 5 mm) (45.0% vs 18.9%; p= 0.018), incarcerated gallbladder neck stones (55.0% vs 22.3%; p= 0.005), and abscess around the gallbladder (20.0% vs 1.4%; p= 0.002) were seen significantly more frequently during imaging in group A vs group B, respectively. Furthermore, investigating patients' surgical outcomes revealed a higher conversion rate to open surgery (20.0% vs 2.0%; p= 0.004), longer operation time (137 min vs 102 min; p< 0.001), and a higher incidence of intraoperative complications (10.0% vs 0%; p= 0.014) in group A vs group B, respectively. Conclusions Our results suggest that a history of severe cholecystitis is a risk factor for developing acute cholangitis and cholecystitis in patients waiting for surgery, and a risk factor for increased surgical difficulty.

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Risk factors for early wheezing in preterm infants: a retrospective cohort study

10.21203/rs.3.rs-42409/v2 ◽

2020 ◽

Author(s):

Xun Chen ◽

Minjing Yang ◽

Shengzhu Huang ◽

Xiaolian Qin ◽

Zhijian Pan ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Family History ◽

Preterm Infants ◽

Full Term ◽

Term Infants ◽

History Of ◽

Group A ◽

Male Sex ◽

Group B

Abstract Background: The factors that cause recurrent wheezing in children are complex, and premature delivery may be one of these factors. Little is known about early wheezing in preterm infants.Methods: Data were sourced from 1616 children born between 2007 and 2013 from 8 hospitals in Guangxi, China. All children were followed up by telephone or questionnaire through the sixth year of life. Children were grouped by gestational age (GA): Group A, GA ≤ 32 weeks; Group B, 32 weeks < GA < 37 weeks; and Group C, 37 weeks ≤ GA < 42 weeks.Results: The incidences and risk factors for early wheezing in preterm infants were analysed. The incidences of early wheezing were as follows: Group A > Group B > Group C. The incidence of persistent early wheezing in Group A or Group B was significantly higher than that in Group C, respectively. SGA (95% CI: 1.097 to 7.519) was a risk factor for early wheezing in group A. Male sex (95% CI: 1.595 to 4.501) and family history of allergies (95% CI: 1.207 to 3.352) were risk factors for early wheezing in group B.Conclusions: 1. New-borns with younger GAs had a higher risk of early wheezing. 2. The incidence of persistent early wheezing for preterm infants (GA ≤ 32 weeks and 32 weeks < GA < 37 weeks) was higher than that for full-term infants (37 weeks ≤ GA < 42 weeks). 3. SGA was a risk factor for early wheezing in preterm infants with a GA ≤ 32 weeks. 4. Male sex, personal history of allergies and family history of allergies were all possible factors affecting early wheezing in preterm infants with a GA > 32 weeks but < 37 weeks and full-term infants. Among them, male sex and family history of allergies were risk factors for early wheezing. 5. Mode of delivery, passive smoking, breastfeeding and invasive mechanical ventilation were not possible risk factors for early wheezing in infants of different GAs.

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Acute Myeloid Leukemia in the Context of Previous History of Cancer with or without Exposure to Chemotherapy or Radiotherapy

Blood ◽

10.1182/blood-2021-145745 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 3368-3368

Author(s):

Kebede H. Begna ◽

Mithun V. Shah ◽

Naseema Gangat ◽

Hassan B. Alkhateeb ◽

Mrinal M. Patnaik ◽

...

Keyword(s):

Research Funding ◽

Previous History ◽

Cell Transplant ◽

Advisory Committees ◽

Free Survival ◽

Allogenic Stem Cell Transplant ◽

History Of ◽

Group A ◽

Group B ◽

History Of Cancer

Abstract Background: Therapy-related acute myeloid leukemia (AML) is a well-described entity and known to carry a worse prognosis, compared to de novo AML. In the current study, we sought to describe the presenting features and outcome of patients with AML, in the setting of previous history of cancer with or without exposure to chemotherapy or radiotherapy. Methods: A Mayo Clinic database of patients with AML was queried to identify patients with a previous history of cancer, both hematologic and solid tumors. A comparative analysis of presenting features, treatment details and survival were performed between patients with therapy-related AML (Group A) and those with AML and a history of cancer that had been managed with surgery alone (Group B). Results: A total of 250 patients (median age 68 years, range 19-90; 60% males) with AML and a previous history of cancer (both hematologic and solid) were identified; 182 (73%) cases were determined to be therapy-related AML (Group A) while the remaining 68 (27%) did not receive chemotherapy or radiotherapy for their antecedent cancer (Group B) (Table). Among group A patients 106 (58%) were exposed to chemotherapy, 37 (20%) to radiotherapy and 39 (22%) to combination chemotherapy and radiotherapy for their cancer. At the time of AML diagnosis, adverse karyotype was noted in 91 (51%) group A and 12 (19%) group B patients (p<0.0001); the incidence of adverse karyotype in patients exposed to chemotherapy vs radiotherapy alone vs combined chemoradiotherapy was 54% (57/106), 30% (11/37), and 59% (23/39) respectively (p=0.04). Group A patients, compared to those in group B, included more females (46% vs 24%; p=0.001), and more preceding hematologic malignancies (p=<0.0001). Next generation sequencing was performed in 74 patients and the results showed no significant difference between groups A and B (Table). Treatment and outcome in Groups A and B: Intensive and less intensive AML-directed chemotherapy were given to 100 (55%) and 44 (24%) patients in group A and 38 (56%) and 14 (21%) patients in group B (P=0.8). 79 (65%) remissions (complete remission (CR) 42 (29%) and CR with incomplete count recovery (CRi) 37 (26%) were documented in Group A and 37 (71%) remissions (CR: 21 (40%) and CRi=16 (31%) in Group B (P=0.2). After a median follow-up of 8.4 months (range: 0.9-217), 184 deaths were documented: 132 (72.5%) in Group A and 52 (76.5%) in Group B (P=0.5). 52 (36%) patients from Group A and 25 (48%) from Group B relapsed (P=0.1). The median (range) overall survival (OS) rates of patients from Group A was 13 (9-17) months and that of Group B was 14 (10-35) months (P=0.6). The 1-, 3- and 5-year OS rates were 52%, 28%, and 24% in Group A; and 62%, 33%, and 24% in Group B patients (Fig 1). Multivariable analysis identified relapse (HR 2.8, 95% CI 1.7-4.7) and failure to achieve CR/CRi (HR 2.8 95% CI 1.9-4.7) as risk factors for inferior survival (Fig 2a and 2b). The median (range) relapse free survival of patients in Group A was 28 (17 -81) and that of Group B was 27 (14 - 76) months (P=0.9) (Fig 2c). 28 patients underwent allogenic stem-cell transplant (25 in CR1 and 3 in CR2), 23 in Group A and 5 in Group B; the 1-, 3-, and 5-year OS of patients who underwent allogenic stem cell transplant were 88%, 72%, and 72% regardless of the group (Fig 2d). Conclusion: The current study did not find significant differences between AML patients with previous history of cancer with or without exposure to chemo/radiotherapy, in terms of either response to AML-directed therapy or overall or relapse-free survival, despite a higher prevalence of adverse karyotype in therapy-related AML. Figure 1 Figure 1. Disclosures Patnaik: Kura Oncology: Research Funding; Stemline Therapeutics: Membership on an entity's Board of Directors or advisory committees; Stemline Therapeutics: Membership on an entity's Board of Directors or advisory committees. Al-Kali: Astex: Other: Research support to institution; Novartis: Research Funding. Litzow: Pluristem: Research Funding; Actinium: Research Funding; AbbVie: Research Funding; Astellas: Research Funding; Amgen: Research Funding; Jazz: Other: Advisory Board; Omeros: Other: Advisory Board; Biosight: Other: Data monitoring committee.

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Gestational diabetes mellitus: does treatment modality predict the obstetric and neonatal outcome?

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175858 ◽

2017 ◽

Vol 7 (1) ◽

pp. 262

Author(s):

Lopamudra B. John ◽

Reddi Rani P. ◽

Seetesh Ghose

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Neonatal Outcome ◽

Previous History ◽

Treatment Modalities ◽

History Of ◽

Group A ◽

Group B ◽

The Impact

Background: Gestational diabetes mellitus (GDM) may be controlled with dietary modifications alone or may require insulin treatment. This study aims to find out the impact of these two treatment modalities on the maternal and neonatal outcomes.Methods: This retrospective observational study divided the GDM patients into two groups, A and B, treated with diet and insulin therapy respectively and the maternal and neonatal outcome parameters were compared.Results: 299 (6.7%) GDM patients over a period of two years were divided into group A (n=222) and group B (n=77). Need for induction of labour was significantly higher in group B (p=0.02). More number of history of previous abortions were seen in group A (p=0.1) and higher number of emergency Caesarean sections were observed in group B (p=0.1). Previous history of intrauterine deaths, gestational hypertension and hypothyroidism in the present pregnancy, meconium stained liquor, large for gestational age babies and need for neonatal intensive care were comparable in the two groups.Conclusions: There are no significant differences in the pregnancy outcomes of GDM treated with diet therapy alone or insulin except for a higher number of induced labours in the insulin treated group.

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Analysis of Corneal Astigmatism after Clear Corneal Phacoemulsification : A Prospective Study

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i2.31371 ◽

2020 ◽

Vol 5 (2) ◽

pp. 1001-1005

Author(s):

Nisha Agrawal ◽

Lalit Agarwal ◽

Reena Yadav ◽

Archana Kumari ◽

Kinsuk Singh ◽

...

Keyword(s):

Cataract Surgery ◽

Care Center ◽

Previous History ◽

Ocular Surgery ◽

Postoperative Astigmatism ◽

History Of ◽

Group A ◽

Induced Astigmatism ◽

Group B ◽

A Prospective Study

Introduction: With the evolution of cataract surgery over the past years and increasing patient demand for spectacle independence, today cataract surgery is moreover a refractive surgery. Surgically induced astigmatism (SIA) hinders post-operative refractive precision by changing the refractive power of cornea. Objectives: To calculate and compare SIA and postoperative spherical equivalent (SE) among eyes undergoing phacoemulsification performed via superior and temporal approach. Methodology: A longitudinal prospective observational study was conducted in a tertiary eye care center. 200 consecutive patients who underwent 2.8mm clear corneal phacoemulsification were allocated in Group A (Superior) and Group B (Temporal) in equal numbers by random lotiery method. Patients with any corneal pathology, glaucoma, retina or macular diseases, with previous history of trauma or ocular surgery were excluded. Preoperative astigmatism, postoperative astigmatism and postoperative SE were calculated at 6weeks follow-up. SIA was calculated using vector analysis software version 2.1 given by Dr Sawhney. Results Eighty patients of group A and 99 patients of Group B were included in the analysis. Preoperative keratometry and astigmatism was comparable between the two groups. Postopera tive astigmatism was significantly lower in temporal incision (0.75± 0.58) group than in superior incision group (1.2±0.71). SIA in-group A was 0.43D and in group B was 0.18D. SE was found to be significantly lower in temporal incision (p<0.01) group. Conclusion Temporal incision is astigmatically more neutral and has betier refractive precision than superior incision clear corneal phacoemulsification.

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Latent Genital Tuberculosis – A Causative Factor for Ectopic Pregnancy- A Retrospective Analysis

Journal of Clinical Research and Reports ◽

10.31579/2690-1919/064 ◽

2020 ◽

Vol 3 (5) ◽

pp. 01-06

Author(s):

Siddhartha Chatterjee

Keyword(s):

Ectopic Pregnancy ◽

Retrospective Analysis ◽

Statistical Significance ◽

Previous History ◽

Pelvic Surgery ◽

P Value ◽

Genital Tuberculosis ◽

History Of ◽

Group A ◽

Group B

Background: Ectopic tubal pregnancy (ETP) is a dreadful situation for both the patient and the doctor. Prevalence of ETP is increasing because of availability of convenient and modern modalities for the diagnosis of ectopic pregnancy. Patients are aware of the condition and many lives can be saved when diagnosed and managed at an early stage; still almost 10% of maternal deaths are due to ETP. The etiology of ETP remains unknown in almost half of the cases and hence the risk of recurrence remains high. The present study has been conducted to screen patients with history of tubal ectopic pregnancyand to determine the role of tubercular infestation of the eutopicendometrium as an important etiological factor in ‘unexplained’ ectopic. Results: This retrospective analysis was conducted at Calcutta Fertility Mission in Kolkata, India, from January 2010 to December 2018. Of 282 patients with history of ETP,who were selected, 109 were in Group A, 72 of them in Group B and 101 in Group C. Tubercular infestation of the endometrium (DNA-PCR positive) was found in all (109) patients in Group A, and others in Group B and C had previous history of pelvic surgery or endometriosis, pelvic infection or unexplained infertility associated with tubercular infestation of the endometrium. In our study latent genital tuberculosis has been proved to be a statistically significant factor for ETP. (p value - <0.001) Moreover other factors like tubal surgeries (p value - <0.001) or correction of minor tubal defects (p value – 0.024); endometriosis (p value- <0.001) and pelvic inflammatory disease (p value -<0.001), have shown statistical significance in causing ectopic pregnancy. Clinical pregnancy rate (p value -0.002) and live birth rate (p value-<0.001) has been proved to be statistically significant after treatment of ETP. Conclusion: Along with the documented causes of ETP tubercular infestation of the endometrium should be considered as an important etiology for ectopic pregnancy and should be screened on a routine basis for early intervention and treatment.

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"Secondary Chronic Myeloid Leukemia": Comparison between Patients Previously Exposed or Not to Chemo and/or Radiotherapy

Blood ◽

10.1182/blood-2018-99-119545 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 5437-5437

Author(s):

Francesco Autore ◽

Federica Sora ◽

Patrizia Chiusolo ◽

Mario Annunziata ◽

Alessandra Iurlo ◽

...

Keyword(s):

Median Time ◽

Previous History ◽

Cytogenetic Response ◽

Molecular Response ◽

Haematological Malignancies ◽

Primary Resistance ◽

Secondary Resistance ◽

History Of ◽

Group A ◽

Group B

Abstract Introduction. Haematological malignancies related to previous chemo and/or radio-therapy for neoplasia have been well investigated. This subgroup was defined as therapy-related myeloid neoplasms by ELN. In the field of chronic myeloid leukaemia (CML) the diagnosis of a secondary neoplasia after CML diagnosis has been studied but the presence of 'secondary CML' has not been completely defined. In clinical practice we collected patients with a CML diagnosis who had a previous history of malignancy. Aim and methods. We reviewed our databases to collect the cases of 'secondary CML' in 4 hematological Italian centres. Results. We found 51 patients who were diagnosed with previous malignancies out of 617 CML patients (8.3%). We conducted the analysis on 48 patients, removing the other three patients who were diagnosed before the era of tirosine-kinase inhibitors (TKIs). We then subdivided patients in two groups according to the treatment they received for the previous neoplasia: patients treated by surgery (group A: 27 patients) and patients treated by chemotherapy and/or radiotherapy (group B: 21 patients). Clinical characteristics at diagnosis of the patients of the two groups were summarized in Table 1. The majority of the patients showed bcr-abl b3a2 (59% in group A and 62% in group B), no one showed additional cytogenetic abnormalities. The median time between the diagnosis of the primary neoplasia and CML were not different: 78 months (range 1-276) in the group A and 75 months (range 1-371) in the group B. Upfront treatment was Imatinib in 55.6% of the patients in group A and 81% in group B; the remaining patients were treated with Dasatinib in 22.2% and 14% of the patients, respectively, and Nilotinib 22.2% and 5% of the patients, respectively. All patients achieved haematological response after 1 month, 24 out of 27 patients (89%) of the group A achieved complete cytogenetic response after a median time of 3 months (range 3-28) and 20 out of 21 patients (95%) of the group B achieved complete cytogenetic response after a median time of 3 months (range 3-12). The median time of major molecular response was 9 months in 20 out of 27 patients (74%) of group A and in 19 out of 21 patients (90%) of group B. Patients in group A showed a higher number of events who determined a change in the treatment: 9 patients (33.3%) in group A changed TKI due to resistance (3 patients: 2 primary resistance and 1 secondary resistance) or intolerance (6 patients) versus 4 patients (19%) of the group B because of resistance (3 patients: 2 primary resistance and 1 secondary resistance) or intolerance (1 patient). We recorded 3 deaths: 2 in the group A not related to CML and 1 in the group B due to CML. The median overall survival was 53 months (range 8-228) in the first group and 51 months (range 4-196) in the second group. Unexpectedly we found a 12.5% of patients with a previous diagnosis of lymphoma in patients developing CML and this reached statistical significance (p=0.004) when compared to patients in A group. We also detected 3 out of 48 CML patients (6%) with a previous history of 2 neoplasia and all of them were treated with chemo and/or radiotherapy. Conclusion. Our research found that "secondary CML" occurred in 8.3% of newly diagnosed CML patients. Patients were comparable in terms of bcr-abl transcript, risk assessment, clinical and laboratory presentation. Cytogenetic and molecular response to TKIs as well as survival was similar to CML standard population. A significant fraction of patients with "secondary CML" received prior chemo and /or radiotherapy for an haematological malignancies and poses new questions in terms of either genetic predisposition and/or exposure to anticancer treatment. Disclosures No relevant conflicts of interest to declare.

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Abdominal Ascariasis: Where to Focus on Imaging Studies

Galician Medical Journal ◽

10.21802/gmj.2020.3.5 ◽

2020 ◽

Vol 27 (3) ◽

pp. E202035

Author(s):

Jan Suhail ◽

Omair Shah ◽

Obaid Shah ◽

Jan Sarfaraz ◽

Irshad Mohuiddin

Keyword(s):

Previous History ◽

Imaging Features ◽

Peripheral Eosinophilia ◽

Imaging Studies ◽

Evaluation Protocol ◽

Objective Evidence ◽

History Of ◽

Group A ◽

Group B ◽

Worm Migration

Objective: To assess the various presentations of abdominal ascariasis and their imaging features for developing a comprehensive radiological evaluation protocol. Methods: Demographic and clinical profile of 84 patients with abdominal ascariasis was noted. Patients were divided into 2 groups with age less than 20 comprising Group A and those with age greater than 20 Group B. All the patients had a routine lab workup and a dedicated USG scan to look for objective evidence of intestinal or hepatobiliary ascariasis. Any history of previous intervention (cholecystectomy or ERCP) was also sought. Results: Abdominal ascariasis is more common in females observed in 62% of our patients. Peripheral eosinophilia was observed in 70 (83%) patients. We had 74 (88%) patients with intestinal ascariasis with 2 patients having appendicular ascariasis. Biliary ascariasis was observed in 20 (24%) patients and pancreatic ductal ascariasis in 6 (7%) patients. We found peritoneal ascariasis in 1 (2%) pediatric patient and 2 (3%) patients in our study had ascariasis associated with the liver abscess. OCH was observed in 4 patients while 2 patients presented with worm cholecystitis. Conclusion: Peripheral eosinophilia can be used to select patients in endemic regions for undergoing a dedicated USG scan. USG is the investigation of choice for both intestinal and hepatobiliary ascariasis. Worm migration is more common in adults and is especially prevalent in individuals with previous history of ERCP or cholecystectomy.

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Appreciation of the importance of pregravid preparation and reproductive attitudes of women of childbearing age in the city of Omsk

GYNECOLOGY ◽

10.26442/20795696.2018.6.180076 ◽

2018 ◽

Vol 20 (6) ◽

pp. 48-52

Author(s):

E N Kravchenko ◽

R A Morgunov

Keyword(s):

Women Of Childbearing Age ◽

Childbearing Age ◽

Pregnancy And Childbirth ◽

Perinatal Center ◽

History Of ◽

Group A ◽

Group B ◽

Complicated Pregnancy ◽

The Relationship ◽

The City

The aim of the study. Assess the importance of pregravid preparation and outcomes of pregnancy and childbirth, depending on the reproductive attitudes of women in the city of Omsk. Materials and methods. The study included 92 women who were divided into groups: group A (n=43) - women whose pregnancy was planned; group B (n=49) - women whose pregnancy occurred accidentally. Each group was divided into subgroups depending on age: from 18 to 30 and from 31 to 49 years. For each patient included in the study, a specially designed map was filled out. These patients were interviewed at the City Clinical Perinatal Center. Results. Comparative analysis revealed the relationship between the reproductive settings of women of childbearing age and the peculiarity of the course of pregnancy and childbirth in these patients. Summary. The majority of women of fertile age are married: in subgroup AA - 25 (96.2%), AB - 13 (76.5%), BA - 25 (92.6%), BB - 20 (91.0%). The predominant number of women of fertile age have one or more abortions: in subgroup AA - 12 (46.2%), AB - 6 (35.3%), in subgroups of comparison BA - 8 (29.6%), BB - 6 (27.3%). More than half of the women of fertile age surveyed have a history of untreated cervical pathology (from 40.8% to 64.7%). The course of pregnancy in women planning pregnancy in most cases proceeded without complications: in subgroup AA - 13 (50.0%), AB - 11 (64.7%). The most common cause of complicated pregnancy in women whose pregnancy occurred accidentally is the threat of spontaneous miscarriage: in subgroup BA - 15 (55.6%), BB - 16 (72.7%). The uncomplicated course of labor more often [subgroup AA - 19 (73.0%), AB - 12 (70.6%)] was observed in women whose pregnancy was planned and they were motivated to give birth to a healthy child.

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Anterior approach levator plication for congenital ptosis, absorpable versus non absorpable sutures

European Journal of Ophthalmology ◽

10.1177/11206721211005320 ◽

2021 ◽

pp. 112067212110053

Author(s):

Moustafa Salamah ◽

Ashraf Mahrous Eid ◽

Hani Albialy ◽

Sherif Sharaf EL Deen

Keyword(s):

Randomized Study ◽

Early Postoperative Period ◽

Polyglactin 910 ◽

Exclusion Criteria ◽

Congenital Ptosis ◽

History Of ◽

Group A ◽

Group B ◽

Over Time

Purpose: To compare the efficacy of two different suture types in levator plication for correction of congenital ptosis. Subjects and methods: Prospective comparative interventional randomized study involving 42 eyes of 42 patients aged more than 6 years with congenital ptosis and good levator action. The exclusion criteria were as follows: bilateral ptosis, history of previous surgery, fair or poor levator action, and associated other ocular diseases. Patients were randomized into group A, in which double-armed 5/0 polyester Ethibond were used, and group B, in which double-armed 5/0 Coated Vicryl® (polyglactin 910) suture material we used. Outcomes including eyelid height and stability of eyelid height over time were compared with follow-up data. The MRD was 4.05 ± 0.36 mm and 3.95 ± 0.34 after 1 week for both groups A and B, respectively. At the end of study follow up period (24 weeks), the MRD was 3.60 ± 0.42 mm in group A, and 2.52 ± 0.85 mm in group B. Conclusion: No difference in eyelid height between two groups in early postoperative period, but the postoperative eyelid height was more stable over time in the 5/0 polyester Ethibond group (group A) than in the 5/0 Coated Vicryl® (polyglactin 910) group (group B).

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Accuracy Computer-Guided Implant Placement using 3D Planning Software

10.37191/mapsci-jdr-1(1)-004 ◽

2020 ◽

Author(s):

Gagik Hakobyan

Keyword(s):

Survival Rate ◽

3D Modeling ◽

Treatment Time ◽

Intraoperative Complications ◽

Marginal Bone Loss ◽

Surgical Time ◽

Surgical Guide ◽

Minimal Trauma ◽

Group A ◽

Group B

Purpose: To evaluate the effectiveness of implant treatment using computer 3D modeling and surgical guided. Materials and Methods: The study included 148 patients who underwent prosthodontics rehabilitation using dental implants in 2015-2020. 3D computer-aided modeling and surgical guide were used to plan the operation. To conduct a comparative analysis of the treatment results, two groups were formed: In group A (included 75 patients, fully guided surgery), in group B (included 73 patients). Results: In patients Group A intraoperative or immediate postoperative complications were noted (errors in the position, inclination), anatomical risk structures were invaded, after 3 years producing a survival rate of 96.2% In patients Group B, intraoperative complications were recorded; membrane perforation 4, errors in the position of the implants 16, the inclination of the implants 18, fenestration 12, after 3 years producing a survival rate of 97.6%. Mean marginal bone loss (MBL) patients in Group A were significantly higher than patients in group B (p < 0.05). In patients Group A the average surgical time from time of anesthesia to the placement of the healing abutment was 10.6 ± 2.9 min per implant, in patients Group B, the average surgical time was 16.4 ± 1.5 min per implant. Conclusion: The 3D modeling method and the controlled positioning of the implant allows surgical access with minimal trauma, reducing treatment time and complications.

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